Vertebrate Localities Research Articles

Spine X-ray image segmentation based on deep learning and marker controlled watershed

Background The development of automatic methods for vertebral segmentation provides the objective analysis of each vertebra in the spine image, which is important for the diagnosis of various spinal diseases. However, vertebrae have inter-class similarity and intra-class variability, and some adjacent vertebrae exhibit adhesion. Objective To solve the adhesion problem of adjacent vertebrae and ensure that the boundary between adjacent vertebrae can be accurately demarcated, we propose an image segmentation method based on deep learning and marker controlled watershed. Methods This method consists of a dual-path model of localization path and segmentation path to achieve automatic vertebral segmentation. For the vertebral localization path, a high-resolution network (HRNet) is used to locate vertebral center. Moreover, based on spine posture, a new bone direction loss (BD-Loss) is designed to constrain HRNet. For the vertebral segmentation path, we proposed a VU-Net network to achieve vertebral preliminary segmentation. Additionally, a position information perception module (PIPM) is introduced to realize the guidance of HRNet to VU-Net. Finally, we novelly use the outputs of HR-Net and VU-Net deep learning networks to initialize the marker controlled watershed algorithm to suppress the adhesion of adjacent vertebrae and achieve vertebral fine segmentation. Results The proposed method was evaluated on two spine X-ray datasets using four metrics. The first dataset contains sagittal images of the cervical spine, while the second dataset contains coronal images of the whole spine, both with different health conditions. Our method achieved Recall of 96.82% and 94.38%, Precision of 97.24% and 98.14%, Dice coefficient of 97.03% and 96.22%, Intersection over Union of 94.24% and 92.72% on the cervical spine and whole spine datasets respectively, outperforming current state-of-the-art techniques.

THE FIRST CENOZOIC OCTOPOD: A LOWER EOCENE RECORD FROM BOLCA, NORTHEASTERN ITALY

To date, soft-tissue remains of extinct incirrate octopods have been described exclusively from UpperCretaceous deposits. Here, three specimens of an incirrate octopodid with well-preserved soft tissue imprints are described for the first time from Paleogene strata. This material originates from the upper Ypresian (lower Eocene) fish-bearing levels of the Bolca Konservat-Lagerstätte in the Pesciara of Bolca in north-eastern Italy. Previously, these specimens had tentatively been interpreted as teuthids. Based on a detailed study of their anatomical structure, a new genus and species of octopodid, Bolcaoctopus pesciaraensis, belonging to the extant family Octopodidae, are here erected. Bolcaoctopus gen. nov. may be distinguished from the Late Cretaceous genus Styletoctopus by the presence of long and thin arms and an elongated body shape with a narrowed apical end and covered by longitudinal wrinkles. Although finds of fossil octopuses in the Bolca Konservat-Lagerstätte remain extremely rare, it is worth noting that Cenozoic marine vertebrate localities constitute an important potential source of additional finds of coleoid cephalopods, the study of which may shed light on a poorly understood period in the evolutionary history of these molluscs.

The first record of gars (Ginglymodi: Lepisosteidae) from the Upper Cretaceous of Bulgaria reveals a wider paleogeographic distribution of lepisosteids within the European Archipelago

The bony-fishes of the clade Lepisosteidae, commonly called ‘gars’ or ‘gar-fish’, are a lineage of proficient piscivores with evolutionary history spanning about 150 million years, which are today represented by two genera inhabiting the freshwater and brackish areas of southeastern North America, Central America, and Cuba. This was not the case during the Late Cretaceous when lepisosteids were more diverse and had much wider geographical distribution. Gar fossils, albeit very fragmentary, are a common component of the Upper Cretaceous freshwater and brackish vertebrate assemblages in Europe, yet all of the pre-upper Campanian records come from the western and central parts of the Late Cretaceous European Archipelago. Here we describe new lepisosteid material from Bulgaria, comprising nine teeth and three scales found at the uppermost Santonian–lowermost Campanian Vrabchov Dol vertebrate locality. These fossils represent the easternmost record of gars within the European Archipelago to date. Despite being found in a lagoonal to foreshore deposits, the paleontological content of the locality, the incompleteness and preservational state of the material, as well as the predominantly non-marine ecology of modern and fossils gars suggest that these fossils belong to fishes which inhabited more inland, freshwater environments. The Vrabchov Dol lepisosteids remains are the first record of gars in Bulgaria and one of the rare documented occurrences of Mesozoic osteichthyans in the country. This material expands the paleobiogeographic distribution of the Lepisosteidae within the European Archipelago.

Chronic pyogenic spondylitis in patients with spinal gout: a case series and literature review

Background. Spinal gout is a rare and poorly described group of noninfectious inflammatory spinal lesions characterized by the deposition of monosodium urate crystals in the epidural space, paravertebral soft tissues, and by facet joints damage. There is no systematized data on the course of infectious spondylitis and spinal gout in the literature. The aim of the study — to present long-term outcomes of surgical treatment of chronic pyogenic spondylitis in patients with spinal gout and systematize the literature data on the issue. Methods. The clinical part of the study included 6 consecutively operated patients in the period from 2018 to 2021. The diagnosis of spinal gout and chronic pyogenic spondylitis was verified according to the results of histologic and bacteriologic studies of surgical material. Catamnesis accounted for at least 12 months. We studied the peculiarities of clinical and laboratory, radiological and histologic manifestations of the disease. Literature data systematization was carried out in the databases PubMed, Google Scholar, eLIBRARY from 2013 to 2023. Inclusion criteria: level of evidence II B-IV, catamnesis more or equal to 6 months, information on diagnostic and treatment measures. Results. The average age of the patients was 55±9 years. The duration of the diagnostic pause was 8±5 years. Multisegmented lesions of the lumbar (n = 6) spine prevailed. According to the classification of Pola E. et al. (2017) the following types of spondylitis were identified: B.3 (n = 1), C.1 (n = 1), C.3 (n = 2) and C.4 (n = 2). The clinical manifestation was dominated by chronic back pain with an intensity of 6,1±1,4 VAS scores. Neurologic disorders of the lower extremities and pelvic (ASIA scale) corresponded to types B (n = 1) and C (n = 4). The type of surgery: three-column reconstruction through combined approach in 2 cases and isolated anterior column reconstruction in 2 cases, 360° fusion in 1 case, and debridement of the epidural space and anterior column through posterior approach in 1 case. The follow-up results show the absence of recurrence of spondylitis in 4 cases, in 2 patients there were postoperative complications that required revision, after which no recurrence of spondylitis was noted. We selected 17 publications for literature review. Conclusion. The combination of chronic pyogenic spondylitis and spinal gout is a rare and poorly described pathology in the literature. Long therapeutic pause, chronic character of vertebrogenic pain syndrome in combination with increased uric acid level and formation of tophi of vertebral localization are distinctive features of the disease. Neurologic disorders with the combination of spondylitis and gout result from stenosis of the spinal canal due to two factors — epidural abscesses and tophi. Achieving local control of the combined pathology is possible with a combination of surgical intervention and long-term administration of hypouricemic drugs.

Валентин Петрович Твердохлебов (1933–2023)

Dedication to the memory of a colleague, Doctor of Geological and Mineralogical Sciences Valentin P. Tverdokhlebov, a well-known specialist in sedimentology and palaeogeography of the Late Permian and Triassic of the Eastern Russian Plate and Southern Urals, as well as taphonomy of vertebrate localities. Valentin Petrovich is a long-time head of the geological survey party investigating the stratigraphy of continental red-coloured strata, tectonics and placement of minerals in the Orenburg region. He co-authored a number of geological maps of the region. He participated in field work as a member of the joint Soviet-Mongolian palaeontological expedition in the Gobi Desert.

Spectrum of Surgical Site Infection Pathogens in Chronic Infectious Spondylitis Requiring Revision Surgery: A 5-Year Cohort Study.

Background: Spectrum monitoring of the pathogen in spondylitis patients plays a key role in preventing infectious complications of spinal reconstructions in chronic spondylitis (CS) and in the treatment of surgical site infection (SSI). The aim of this study is to characterize the spectrum of SSI pathogens in CS requiring revision surgery. Methods: The primary cohort encompassed 569 surgical patients with infectious CS. In 99 patients (61 men and 38 women) requiring revision surgical interventions due to SSI, continuous microbiological monitoring of the pathogens was conducted. The average age of the patients was 63 ± 14 years. The vast majority of the patients underwent surgery on a set of multilevel (two or more spinal-motor segments) lesions. Lesions of the lumbar spine were more often noted, and lesions of the thoracic, thoracolumbar, and cervical spine sections were less often noted. This study included all patients operated on within the scope of revision spinal reconstructions in connection with the development of infection of the surgical area over the period from January 2018 to December 2022. Inclusion criteria were etiologically verified spondylitis, age of 18 years or older, and follow-up of 6 months or more. Results: The average rate of revision surgery due to SSI was 17.4%. Germ detection from the material of vertebral localization was noted in 48.3% and pathogen strains were isolated in urine in 60.8%, in decubital ulcers in 23.9%, and in hemoculture in 15.2% of all study patients. Aseptic, deep SSI was detected in 10.1%. Gram-positive, multidrug-resistant, and Gram-negative bacteria with extreme resistance prevailed in the microbiological landscape of late SSI, early, and delayed Gram-positive strains without drug resistance. Conclusions: Infectious etiology of spondylitis is associated with a significantly higher frequency of SSI. In the absence of a positive result from bacteriological examination of the vertebral localization material, it is advisable to conduct blood, decubital ulcer discharge, and urine sampling.

Palaeontological and taphonomical investigations of the exceptionally rich concentration of Miocene vertebrate coprolites from Pécs-Danitzpuszta (Hungary, Mecsek Mts.)

ABSTRACT Thousands of coprolites have been collected from the Upper Miocene (Tortonian/Pannonian) sands of the Pécs-Danitzpuszta sand pit, one of the most important mixed Neogene vertebrate localities in Hungary. Although, the locality has been known for centuries, the coprolites have not been investigated in detail. We describe these fossils and explore their palaeoecological significance. Coprolites were examined with thin sections, X-ray powder diffraction and computed tomography. Their surface is mostly smooth, desiccation cracks were not observed. All coprolites mainly consist of apatite, indicating most probably a carnivorous diet. No evidence of herbivory has been found so far. The coprolites contain remains belonging to several groups: ostracod carapaces, bivalve shells, vertebrae from bony fishes, fish scales, as well as teeth. The CT scans show inhomogeneities in the matrix; however, in most cases they do not reliably indicate inclusions. The taphonomical features suggest rapid burial and most likely an aquatic origin. The spiral morphotype could be attributed to fishes with spiral intestinal valves. Teeth of reef-associated fish taxa indicate Badenian age for some specimens, though the coprolite assemblage might include older and younger specimens as well.

Microbiological spectrum of SSI pathogens in patients with chronic infectious spondylitis requiring revision surgery: results of continuous monocentric 5-year monitoring

Objective. To analyze the results of the continuous monocentric 5-year microbiological monitoring of causative agents of surgical site infection (SSI) in patients who underwent primary surgery for chronic infectious spondylitis and required revision surgery.Material and Methods. The study included patient data from 2018 to 2022. The primary cohort included 569 consecutively operated patients with chronic infectious spondylitis of nonspecific (n1 = 214) and tuberculous (n2 = 355) etiology. The analyzed sample was formed taking into according to inclusion and exclusion criteria. Thus, in 99 patients who required revision surgical interventions due to the development of SSI, a continuous microbiological monitoring of pathogens was performed, including the assessment of drug resistance and the timing of the development of infectious complications. Periodization of the time of SSI development was performed according to the accepted classification of Prinz et al. (2020), the assessment of drug resistance spectrum was performed according to the EUCAST recommendations (2020) and taking into account the approved methodological recommendations.Results. In the general structure of surgical interventions for chronic infectious spondylitis, the share of revision interventions due to the development of SSI was 17.4 %. The highest incidence of complications was noted in the late postoperative period (χ2 = 9.237; p = 0.009). Bacterial detection from the material of vertebral localization was noted in 43 cases (48.3 %), pathogen strains were isolated in urine in 28 (60.8 %), in decubital ulcers in 11 (23.9 %) and in hemoculture in 7 (15.2 %) patients. Culture negative SSI was detected in 10 cases (10.1 %) in the late period. Infectious complications in the setting of chronic non-specific spondylitis were detected more frequently than in spondylitis of tuberculous etiology (χ2 = 21.345; p < 0.001). Gram-positive multidrug-resistant and Gram-negative bacteria with extreme resistance prevailed in the microbiological landscape of late SSI, and Gram-positive strains without drug resistance in that of early and delayed SSI (χ2 = 17.516; p = 0.0032).Conclusion. Drug-resistant Gram-positive bacteria predominate in the structure of SSI with a significantly higher frequency of complication development. Nonspecific etiology of spondylitis is associated with a significantly higher incidence of SSI. In the absence of a positive result of bacteriological examination of the material of vertebral localization, it is advisable to collect blood, decubital ulcer secretion and urine sampling.

A New Basal Neornithischian Dinosaur from the Phu Kradung Formation (Upper Jurassic) of Northeastern Thailand

An exceptional articulated skeleton of a new basal neornithischian dinosaur, Minimocursor phunoiensis gen. et sp. nov., was discovered in the Late Jurassic Phu Kradung Formation at the Phu Noi locality, Kalasin Province, Thailand, a highly productive non-marine fossil vertebrate locality of the Khorat Plateau. It is one of the best-preserved dinosaurs ever found in Southeast Asia. Minimocursor phunoiensis gen. et sp. nov. shows a combination of both plesiomorphic and apomorphic characters resembling those of Late Jurassic to Early Cretaceous small-bodied ornithischians from China: a low subtriangular boss is projected laterally on the surface of the jugal, the brevis shelf of the ilium is visible in lateral view along its entire length, a distinct supraacetabular flange is present on the pubic peduncle of the ilium, the prepubis tip extends beyond the distal end of the preacetabular process of the ilium, and the manus digit formula is ?-3-4-3-2. The phylogenetic analysis shows that this dinosaur is among the most basal neornithischians. This study provides a better understanding of the early evolution and taxonomic diversity of ornithischians in Southeast Asia.

New data on high-latitude hadrosaurid dinosaurs from the Upper Cretaceous Kakanaut Formation of Chukotka, Russia

Fossils from high-latitude Mesozoic vertebrate localities provide a unique opportunity to reveal specific biological features and reconstruct adaptations to months of twilight and relatively low annual temperatures of polar dinosaurs. Here we provide morphological description of new hadrosaurid specimens (vertebrae, femora) and results of the histological analysis of hadrosaurid femora, proximal fragments of a humerus and a scapula from the Upper Cretaceous high-latitude (palaeolatitude estimate of 75°N) Kakanaut locality (Chukotka, Russia). The two studied hadrosaurid femora are different in size and form, but both are histologically mature and belong to fully grown adult individuals. This difference may indicate the presence of two different hadrosaurid taxa in the Kakanaut fauna. The bone histology of the Kakanaut dinosaurs does not differ from that of dinosaurs from lower latitudes and does not show specific histological features (namely, cyclic change of vascularization of the fibrolamellar bone, with sharply defined borders between cycles) found in polar Edmontosaurus from Alaska. This suggests that the Kakanaut hadrosaurid dinosaurs were not significantly stressed, and this may be the result of the local mild and weakly seasonal climate reconstructed from palaeobotanical data. We suggest that Arctic dinosaurs of Chukotka, like other polar dinosaurs, were year-round residents of paleopolar ecosystems.

La Piquera (central Iberian Peninsula): A new key vertebrate locality for the Early Pliocene of western Europe

La Piquera (central Iberian Peninsula): A new key vertebrate locality for the Early Pliocene of western Europe

Multi-perspective region-based CNNs for vertebrae labeling in intraoperative long-length images

PurposeEffective aggregation of intraoperative x-ray images that capture the patient anatomy from multiple view-angles has the potential to enable and improve automated image analysis that can be readily performed during surgery. We present multi-perspective region-based neural networks that leverage knowledge of the imaging geometry for automatic vertebrae labeling in Long-Film images – a novel tomographic imaging modality with an extended field-of-view for spine imaging. MethodA multi-perspective network architecture was designed to exploit small view-angle disparities produced by a multi-slot collimator and consolidate information from overlapping image regions. A second network incorporates large view-angle disparities to jointly perform labeling on images from multiple views (viz., AP and lateral). A recurrent module incorporates contextual information and enforce anatomical order for the detected vertebrae. The three modules are combined to form the multi-view multi-slot (MVMS) network for labeling vertebrae using images from all available perspectives. The network was trained on images synthesized from 297 CT images and tested on 50 AP and 50 lateral Long-Film images acquired from 13 cadaveric specimens. Labeling performance of the multi-perspective networks was evaluated with respect to the number of vertebrae appearances and presence of surgical instrumentation. ResultsThe MVMS network achieved an F1 score of >96% and an average vertebral localization error of 3.3 mm, with 88.3% labeling accuracy on both AP and lateral images – (15.5% and 35.0% higher than conventional Faster R-CNN on AP and lateral views, respectively). Aggregation of multiple appearances of the same vertebra using the multi-slot network significantly improved the labeling accuracy (p < 0.05). Using the multi-view network, labeling accuracy on the more challenging lateral views was improved to the same level as that of the AP views. The approach demonstrated robustness to the presence of surgical instrumentation, commonly encountered in intraoperative images, and achieved comparable performance in images with and without instrumentation (88.9% vs. 91.2% labeling accuracy). ConclusionThe MVMS network demonstrated effective multi-perspective aggregation, providing means for accurate, automated vertebrae labeling during spine surgery. The algorithms may be generalized to other imaging tasks and modalities that involve multiple views with view-angle disparities (e.g., bi-plane radiography). Predicted labels can help avoid adverse events during surgery (e.g., wrong-level surgery), establish correspondence with labels in preoperative modalities to facilitate image registration, and enable automated measurement of spinal alignment metrics for intraoperative assessment of spinal curvature.

Discovery of a crown salamander in the Middle Jurassic (Bathonian) Moskvoretskaya formation of the Moscow Region, Russia

ABSTRACT Crown salamanders first appeared in the Middle Jurassic (Bathonian) and remains of these oldest representatives of the group have been found in various vertebrate localities in China, Western Siberia, and Western Europe. Here, we report the discovery of an indeterminate crown salamander in the Middle Jurassic (Bathonian) Peski locality of Moskvoretskaya Formation of the Moscow Region, Russia. This find (a fragmentary trunk vertebra) represents (1) new occurrence of the oldest crown salamanders; and (2) the first fossil record of crown salamanders in the Middle Jurassic of Eastern Europe. The trunk vertebra from the Peski locality resembles those of the modern crown salamanders of the Salamandroidea clade in the presence of spinal nerve foramina and bicapitate transverse processes. If our assignment of the Peski salamander to Salamandroidea is correct, then it is the oldest salamandroid in the fossil record.

Imaging review in case of cervical spine tuberculosis

Tuberculosis of the cervical spine differs from other vertebral localizations by its extreme rarity, the clinical images are very diversified, the radiological measurements allow a good diagnostic orientation and specifically the MRI which allows a multi-planar study of the various lesions. Only bacteriological evidence can confirm the diagnosis. The treatment is based on a 12-month antituberculosis multidrug therapy and much debate upon the surgical indication. History: In this case, the patient presented with pain in cervical region with restricted movements of the neck and pain on examination at the mobilization of the cervical spine. Biopsy of the cervical lymph node had already been done which was positive for Koch’s etiology. Discussion: Cervical CT scan and a cervical MRI were performed, showing changes of spondylitis involving C1-C3 vertebrae with adjacent large loculated abscess in prevertebral and bilateral paravertebral regions and cord compression at the level of C2 vertebrae. Findings favoring an infective etiology. Conclusion: Cervical spine tuberculosis is considered a catastrophic disease due to the associated probability of spinal cord compression and quadriplegia. This emphasizes the importance of early diagnosis in the management of cervical tuberculosis with radiological and clinicopathological correlation.

Höwenegg Hippotherium primigenium: geological context, cranial and postcranial morphology, palaeoecological and biogeographic importance

ABSTRACT Höwenegg is an early Vallesian (MN9, 10.3 Ma) vertebrate locality in Hegau, Southwest Germany renowned for its preservation of complete mammalian skeletons, diverse invertebrate and plant fossils. We provide the first to be published photographic images of the Höwenegg Hippotherium primigenium skulls, mandibles and dentitions for describing critical character states used to define hipparion species. We compare these states to those for North American Cormohipparion occidentale, Turkish Cormohipparion sinapensis Algerian ‘Cormohipparion’ africanum, Austrian Pannonian C Hippotherium sp., Austrian locality Inzersdorf Hippotherium primigenium, the China type specimens of Hippotherium weihoense and ‘Hipparion’ chiai, and Moldovan Cremohipparion moldavicum. Also provided are univariate statistical comparisons of cranial-dental characters and Log10 ratio analyses of third metapodials dimensions to better evaluate taxonomic comparisons and define the genetic pool from which Old World hipparions are derived. We concur with previous authors that North American Cormohipparion is the likely source of first occurring Old World hipparions offering alternatives of Cormohipparion occidentale or Cormohipparion quinni as the most closely related species for the Old World Cormohipparion Datum. We find that the best evidence for the chronology of the Cormohipparion Datum suggests and age of 11.4–11.0 Ma, or 11.2–11.1 Ma rather than the 11.5 Ma datum recently alleged for China.

Realistic C-arm to pCT registration for vertebral localization in spine surgery

Spine surgeries are vulnerable to wrong-level surgeries and postoperative complications because of their complex structure. Unavailability of the 3D intraoperative imaging device, low-contrast intraoperative X-ray images, variable clinical and patient conditions, manual analyses, lack of skilled technicians, and human errors increase the chances of wrong-site or wrong-level surgeries. State of the art work refers 3D-2D image registration systems and other medical image processing techniques to address the complications associated with spine surgeries. Intensity-based 3D-2D image registration systems had been widely practiced across various clinical applications. However, these frameworks are limited to specific clinical conditions such as anatomy, dimension of image correspondence, and imaging modalities. Moreover, there are certain prerequisites for these frameworks to function in clinical application, such as dataset requirement, speed of computation, requirement of high-end system configuration, limited capture range, and multiple local maxima. A simple and effective registration framework was designed with a study objective of vertebral level identification and its pose estimation from intraoperative fluoroscopic images by combining intensity-based and iterative control point (ICP)–based 3D-2D registration. A hierarchical multi-stage registration framework was designed that comprises coarse and finer registration. The coarse registration was performed in two stages, i.e., intensity similarity-based spatial localization and source-to-detector localization based on the intervertebral distance correspondence between vertebral centroids in projected and intraoperative X-ray images. Finally, to speed up target localization in the intraoperative application, based on 3D-2D vertebral centroid correspondence, a rigid ICP-based finer registration was performed. The mean projection distance error (mPDE) measurement and visual similarity between projection image at finer registration point and intraoperative X-ray image and surgeons’ feedback were held accountable for the quality assurance of the designed registration framework. The average mPDE after peak signal to noise ratio (PSNR)–based coarse registration was 20.41mm. After the coarse registration in spatial region and source to detector direction, the average mPDE reduced to 12.18mm. On finer ICP-based registration, the mean mPDE was finally reduced to 0.36 mm. The approximate mean time required for the coarse registration, finer registration, and DRR image generation at the final registration point were 10 s, 15 s, and 1.5 min, respectively. The designed registration framework can act as a supporting tool for vertebral level localization and its pose estimation in an intraoperative environment. The framework was designed with the future perspective of intraoperative target localization and its pose estimation irrespective of the target anatomy.Graphical abstract

Automated prediction of the Thoracolumbar Injury Classification and Severity Score from CT using a novel deep learning algorithm

Damage to the thoracolumbar spine can confer significant morbidity and mortality. The Thoracolumbar Injury Classification and Severity Score (TLICS) is used to categorize injuries and determine patients at risk of spinal instability for whom surgical intervention is warranted. However, calculating this score can constitute a bottleneck in triaging and treating patients, as it relies on multiple imaging studies and a neurological examination. Therefore, the authors sought to develop and validate a deep learning model that can automatically categorize vertebral morphology and determine posterior ligamentous complex (PLC) integrity, two critical features of TLICS, using only CT scans. All patients who underwent neurosurgical consultation for traumatic spine injury or degenerative pathology resulting in spine injury at a single tertiary center from January 2018 to December 2019 were retrospectively evaluated for inclusion. The morphology of injury and integrity of the PLC were categorized on CT scans. A state-of-the-art object detection region-based convolutional neural network (R-CNN), Faster R-CNN, was leveraged to predict both vertebral locations and the corresponding TLICS. The network was trained with patient CT scans, manually labeled vertebral bounding boxes, TLICS morphology, and PLC annotations, thus allowing the model to output the location of vertebrae, categorize their morphology, and determine the status of PLC integrity. A total of 111 patients were included (mean ± SD age 62 ± 20 years) with a total of 129 separate injury classifications. Vertebral localization and PLC integrity classification achieved Dice scores of 0.92 and 0.88, respectively. Binary classification between noninjured and injured morphological scores demonstrated 95.1% accuracy. TLICS morphology accuracy, the true positive rate, and positive injury mismatch classification rate were 86.3%, 76.2%, and 22.7%, respectively. Classification accuracy between no injury and suspected PLC injury was 86.8%, while true positive, false negative, and false positive rates were 90.0%, 10.0%, and 21.8%, respectively. In this study, the authors demonstrate a novel deep learning method to automatically predict injury morphology and PLC disruption with high accuracy. This model may streamline and improve diagnostic decision support for patients with thoracolumbar spinal trauma.

Preliminarily report on rare earth element taphonomy of a Miocene mixed age fossil vertebrate assemblage (Pécs-Danitzpuszta, Mecsek Mts., Hungary): uptake mechanism and possible separation of palaeocommunities

ABSTRACT The sand pit of Pécs-Danitzpuszta is one of the most important mixed Neogene vertebrate localities in Hungary, with older Miocene (Langhian – Serravallian) terrestrial and marine animal remains re-deposited into the upper Miocene (Tortonian) Lake Pannon sediments. Due to the mixed status of the Pécs-Danitzpuszta vertebrate assemblages, limited information is available about the former depositional environment and age of these fossils. However, the rare earth element (REE) composition of the fossil apatite can help to determine the stratigraphic origin and the early depositional environments of unprovenanced vertebrate remains. In this study, the REE composition of more than 60 vertebrate fossils, among them reworked and in situ remains from the Mecsek Mountain, were analysed. The results allowed separation between the Badenian, Sarmatian, and Pannonian aged fossils. The REE content and their distribution also helped us characterise the ancient depositional conditions of the investigated reworked fossils. Furthermore, several different types of vertebrate fossils were analysed, resulting in a large database that helped clarify the likely timings and mechanisms of REE uptake at this locality. Apparent variation in REE chemistry within bones (cortical vs cancellous) and teeth (enamel vs dentine) are best linked to fractionation along the REE series during their incorporation.

Pinniped (Mammalia: Carnivora) fossils from Black Rock, a new late Neogene vertebrate locality in Victoria, Australia

Pinniped (Mammalia: Carnivora) fossils from Black Rock, a new late Neogene vertebrate locality in Victoria, Australia

Multimodal therapy for synchronous bone oligometastatic NSCLC: The role of surgery

The study aimed to assess the feasibility of radical surgical treatment for selected bone-oligometastatic non-small cell lung cancer (NSCLC) patients and to identify prognostic factors associated with survival. The clinical records of 27 patients with bone synchronous oligometastatic NSCLC were retrospectively analyzed. Thirteen (48.1%) bone metastases were treated by surgery and 14 (51.9%) by local radiotherapy. Eighteen (66.7%) patients underwent induction chemotherapy before lung surgery, and 3 (11.1%) concurrent radiotherapy. Pulmonary surgery was a major lung resection in 23 (85.2%) cases. Intraoperative and 30-days mortality was null. Only one major (ARDS) and 10 (37.04%) mild complications (like air leakage, arrhythmia, and mucus retention) were recorded. 1-year and 5-years OS from the diagnosis and 1-year, 3- years disease-free survival (DFS) were 96%, 38%, and 66%, 30%, respectively. After stepwise Cox regression analysis, local recurrence (p = 0.05) and metachronous metastases (p = 0.04) maintained their independent prognostic value as overall survival negative determinants. Nodal upstaging (p = 0.04) and nonsurgical treatment of bone lesion (p = 0.03) turned out to be independent risk factors for shorter DFS; the vertebral localization of bone metastases showed only a remarkable trend towards significance (p = 0.06) as a risk factor for a worse DFS. In selected patients, surgical treatment of primary NSCLC and bone synchronous metastasis seems to be safe and feasible and rewarding survivals may be expected.